health transformation

EHR 2.0 is the Cornerstone of Health Transformation — From Siloes to Ecosystem

With an integrated care vision and strategy, healthcare providers and health authorities are driving the adoption of a patient-centric and ecosystem-supported platform approach to technology. Next-generation electronic healthcare records (EHR 2.0) will be the main technology pillar underpinning a new patient-centric model of care delivery, entailing personalized medicine, integrated pathways, value-based reimbursement, and omni-channel experiences. This new healthcare vision is the main driver in evolving a new approach to registering, storing, sharing, and using patient data.

The new paradigm of healthcare is not achieved by one monolithic application that can handle everything. Healthcare is about personalization and patient centricity, stakeholder integration, and new value-based incentives, which calls for an enabling and agile centralized platform where an ecosystem of technologies can thrive and support each stakeholder for the good of the patient. When healthcare executives truly align the three pillars and adopt IT as an enabler, a true integrated care delivery model is achievable.

Personalization

For patients, it isn’t about hospital and other pre- or post-acute providers located in their siloes of care management — it is about the journey as a whole. Data created in one instance must be made available in others; this will save lives and increase quality by enabling patient-centric pathways and adopting an evidence-based approach that leverages the new insights from DNA sequencing and personalized medicine, among others. Moreover, sharing data in a healthcare ecosystem will leverage the communication and cooperation across the community of care givers as well as actively engaging with their patients. According to IDC’s European DX Practice Survey (March 2017) on digital transformation (DX) adoption, 50% of respondents said that “improving patient interaction with digital experiences” is their key priority in the next 12 months. This again supports the argument that personalization is a major trend in healthcare.

Integration

Healthcare communities are taking into account variations in demography, prevalence, and incidence of certain diseases, particularly chronic diseases. Innovation in medical procedures and medical technology, as well as persisting cost pressures, are driving the transformation from inpatient to outpatient treatment. There is a focus on the management and guidance of the elderly and the frail in their home environment to avoid hospitalization. Digital transformation is now not only a matter for hospitals, but involves integration of all stakeholders in the ecosystem from the hospital, to community care units, GPs, patients, and their families.

Value

Value is about a change in reimbursement models with a renewed focus on the quality of outcomes instead of volume, as well as decreasing cost. Within the value-based paradigm outcomes are quantified across the full cycle of care, not just on a single encounter. To follow a value-based healthcare approach, healthcare providers will need to plan their services through a care coordination approach, segmenting the health needs of their patients and identifying the most effective pathways.

Value is also about leveraging the vast amount of existing data through Big Data predictive analytics and simulation. EHR 2.0 will provide those capabilities and create the necessary baseline for population health management initiatives across the healthcare ecosystem.

To strive in this new paradigm, healthcare providers need new digital tools to measure and support the delivery of high-quality care across the patient journey. Traditional EHR solutions are not fit for purpose as they do not provide the flexibility to use and share data in different scenarios, supporting patient and healthcare organization needs. A new generation of EHR — EHR 2.0 — is emerging, creating a coherent environment to integrate the different patient data sources and providing a platform for innovation in care service. EHR 2.0 can granularly map care processes at patient and population level, deliver decision support for clinicians, and help middle and top management with status and statistics on how well care quality is delivered in real time.

Reaching the Equilibrium for Persistent DX: Aligning with Business Strategy While Keeping the Architecture Sustainable

When struggling with increasing costs in IT operations and maintenance, legacy architecture, and an increasing number of new requirements from clinical professionals and executive leaders, hospital CIOs must prioritize every day to succeed. Often, existing investments are not able to support this rapid change in processes, business models, or strategic initiates that drives the modern healthcare organization and ecosystem in 2017. IT is often an impediment to innovation instead of an enabler. Using the Business and Digital sustainability matrix, the hospital CIO must align initiatives to the overall healthcare strategy (X-axis) and at the same time evaluate the existing architecture’s sustainability within the organization (Y-axis). The CIO can’t support a new healthcare agenda of personalization, integration, and value with a legacy architecture. At the same time, the potential business value of investments in new technology cannot be leveraged by an obsolete and siloed healthcare strategy.

Healthcare CIOs must consider:

  • Engaging in discussions with executive healthcare leaders on business strategies. Define how personalization, integration, and value are important in the organizations to establish specific DX KPIs.
  • Evaluating the current state of legacy IT with an application and architecture portfolio assessment. Create an IT strategy with corresponding investment roadmap and invest in technologies enabling the EHR 2.0 vision.
  • Engaging with an ICT vendor with an end-to-end IT services portfolio or an equivalent ecosystem consortium. The ICT vendor must have substantial knowledge from infrastructure to industry-specific applications and business change management. The ICT vendor must also be able to support enterprisewide service requests from highly technical to clinical and core business development assignments. ICT vendors must be a partner in moving the healthcare provider toward an integrated care delivery model supported by IT.
  • Applying DevOps and agile frameworks and methodologies in collaboration with the IT service vendor in order to increase rapid development and migration management processes toward a more sustainable architecture. Legacy management, cloud transition, business process management, and enterprise architecture capabilities should be part of the IT services partner’s portfolio.

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Jonas Knudsen

Author: Jonas Knudsen

Jonas Knudsen (Twitter: @JonasHKnudsen) is a research director within IDC Health Insights in EMEA. He is responsible for analyzing key trends related to IT strategies and spending in European healthcare organizations. He advises healthcare organizations and ICT vendors on planning and implementing effective digital health transformation initiatives to drive integrated and personalized care innovation.

Until April 2016, Jonas was the CIO of the New University Hospital Odense, formerly employed by the region of Southern Denmark, and was an associate professor of IT management at the University of Southern Denmark.